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Is it too late/milk not coming in

Hey Ladies,

I'm new here, just had my baby girl last Monday, the 14th. She was an emergency c section and I have heard that c sections, as well as pitocin can cause your milk to come in slowly. I did labor, for 27 hours before the c section happened, 12 of those was with the epidural and on and off with the pitocin. Well I am 8 days out, and while I do have milk now, there is not a lot, it never even leaks. We worked with the lactation consultant at the hospital to correct latching issues, but I'm not 100% we are doing it right, she still seems to fight latching on at first. We are pumping right now and bottle feeding the breastmilk, then making up the rest of the volume with formula so that we can give as little formula as possible. The first time I pump for the day, I will get between 20-30 ml and then progressively it tapers off throughout the day unless I skip a pumping (like today, I had to skip because I left the newborn photographer's house and had to go straight to the surgeons office to get my staples removed) usually I end up around 10-12 ml for the rest of my pumpings, every 2-3 hours. I am doing skin to skin contact, eating lactation oatmeal cookies, resting and drinking lots of water, letting warm water hit my breasts in the shower, eating a balanced diet, and we've begun putting her on breast and then pumping when I take her off (we started this today) In the last 24 hours, my face has gone from cleared up (when I got pregnant and throughout the pregnancy my skin stayed terrible) to all zitty again and my breasts have gotten very tender, and not the nipple its the actual breast, I'm hoping this is a good sign that another hormone is working.

I asked the surgeon today at my staple removal appointment if this is it for milk and she was pretty much "ehhh sounds like you are just going to have to formula feed" she didn't offer any advice or help, note that this is not my normal OB, I only went back to her because she did the c section since my doctor is out of town and was not on call the night I delivered.

Has anyone heard of it taking longer than this for the milk to really start flowing? Do I have any chance of getting her on the breast at this point? I'm starting to get so discouraged, first I couldn't birth my baby and now I feel like I can't even feed her.

Re: Is it too late/milk not coming in

i would first recommend seeing a IBCLC for hands on help. this will be a great way to figure out what you are doing right and to get tips on how you can improve. it will be an incredible help for you!

the baby is going to increase milk supply as long as you keep her at your breast. i used to just sit in my rocking chair and nurse my son all day, keeping him close and at the breast to build my supply. there is nothing better than a baby to build your supply

i am sorry that woman said that to you because it is not true that you need to use formula.

pumping can be very tough long term and having the baby take bottle so early can make it difficult because the liquid flows so fast out of a bottle and they need to learn how to remove milk from the breast.

having the baby close and at the breast will not only provide her with nutrients, she will be comforted by your warmth, your heartbeat. skin to skin contact can be so helpful for little ones. imagine she has been inside you for 9 months, this is a scary place out here, you are her sanctuary and haven.

Re: Is it too late/milk not coming in

mama, sounds like you're having a tough time! i agree with PP - get in to see an IBCLC asap, put the baby to the breast as much as possible. switch your thinking to nurse first, pump second, if you feel that you can. baby is going to be better at getting milk and brinign milk in than pump. and if you can't, then you really need to be pumping every 2 hours religiously to bring in your milk, because a baby would be nursing even more frequently.

not leaking is not a good sign of low supply; some mamas never leak. you might just be lucky on that front.

Re: Is it too late/milk not coming in

Any surgeon or MD for that matter is immediately going to tell you to formula feed. They know nothing about BFing and the only way they know of for sure is to take a cop out and tell you to formula feed. Don't ever take what they say as a gold standard. It sounds like with an emergency c section, I'm sure there wasn't a lot of time for you to be able to immediately put her to the breast following the surgery, and that most of the things you can do in the first few hours and days to get BFing off to the right start couldn't or didn't happen. That may be a cause of SOME of the problems now, but there are several thigns you can do to overcome it. If the latch is in question, then she probably isn't getting as much as what she should be getting and therefore not removing enough milk for your body to realize that it needs to make more. A good latch is crucial to effective milk production. If you are unsure at all about if you are getting a good latch or not, keep seeing the LC. What you are doing sounds great, and I know it's hard but I commend you on working so hard to give your daughter the best. Try a couple of different positions, maybe look up "laid back breastfeeding." It can help with latch problems a lot. Also,bottle feeding can cause nipple preference. Not confusion, but preference. It's where baby can get milk out of the bottle easier than the breast, so when they do nurse, they won't take as much as what they should. There are other methods of supplementation while you work on the latch issue such as syringe or finger feeding and even spoon or cup feedings. You might try those instead of bottle feeding. If you try nursing/pumping about every hour for a while, your supply will increase. Every 3 hours is too long to wait when you are trying to boost milk production. Every hour for about a day and then every 2 for 2 days will make a huge difference. It is imperative that you do not skip a nursing or pumping. If you have a situation where you don't have time to pump, nurse her in the waiting room of the MD office. Get a cover up, or ask for a room. I'm sure they can accommodate you. Remember, the way to make milk is to take milk. After a while, you won't need formula anymore. Good luck!!

Re: Is it too late/milk not coming in

with PPs. Definitely seek out an IBCLC. While there are undoubtably many wonderful LCs working in hospitals, many hospital LCs have only the very most basic training in lactation and are often more trouble than they are worth. Also grab some snacks and water, a good book, laptop, and/or some movies, and camp out on the couch/bed/favorite chair and nurse round the clock. And keep up with the skin to skin - it is very god for you, your baby, and your nursing relationship!

Re: Is it too late/milk not coming in

Welcome to the forum and congratulations on the new baby!

I am with the advice already given. There's absolutely NO REASON to think that you are doomed to use formula. I'd like to the doc who told you that. She must have been sleeping during the 5 minutes of med school where they covered the physiology of milk production.

Here are some suggestions for you, some covered above, some things you may already be doing, but hopefully some new:
- Nurse as much as possible
- Pump every 2-3 hours using a high-quality pump (hospital-grade rental is optimal) with correctly sized breast shields
- See an IBCLC for help with your specific situation
- Reduce the risk of baby coming to prefer the bottle by using slow-flow bottle nipples, making baby practice good latching skills by waiting for her to open wide before putting a bottle nipple in her mouth, and consider using a supplemental nursing system (SNS) or Lact-aid so that baby does all her feeding at the breast
- Speak to your doc about possible physical causes for low supply- retained placenta fragments, thyroid problems (very common postpartum) and PCOS can all impact milk supply

Finally, if you are producing any milk, then your milk is "in". The only issue now is quantity.

Re: Is it too late/milk not coming in

Hey Ladies,

Wanted to come back and give an update. Yesterday and today I have been pumping my butt off, and while my production level is slowly creeping upward (yesterday 75ml, today 81 so far) it seems like I make the most milk at once on the first two pumpings of the day (around 25 ml and then around 20) and then from there I bottom out with about 10 ml each pumping after, and that is combined from both breasts. Also, yesterday we were able to get her successfully latched on a few times, which seems like nothing, but coming from the terrible fits she was throwing and the refusal to latch for a while it is something. For a while I seriously thought she hated me, seriously, it was like she would do anything to get away from my chest to eat, but she was enjoying skin time. The only time she didn't throw a fit like that was in recovery. We had a ton of skin time too which is fine with me since I just like snuggling her.

I forgot to mention it in my first post, but I have horrible breasts, so I'm wondering if that has something to do with the problems she is having latching, I was told my nipples are a tiny bit flat, but my breasts themselves are deformed, they aren't full at all, wide set from each other on my chest, and one is significantly larger than the other. I don't know if that has anything to do with it, but I thought I'd throw it out there.

I plan on getting into my doctor asap so have my thyroid checked and see if there is anything that can be corrected with my hormones.

And stress wise, I found her hospital bracelet (one of my dogs took it and her "coming home" pants and was sleeping with them in his bed, so that was a huge source of disappointment until yesterday, BUT my stupid incision started bleeding a bit so now I'm supposed to go back to taking it really easy which means I'm stuck in bed more when I was just starting to get up and moving around better. UGH.

To answer a few questions, I am using a medella double electric pump, and the LC at the hospital did teach us to make her "work" for the formula that we are supplementing with, using slow drip nipples and opening wide in order to receive the bottle. Also, even though she was an emergency c section her health checked out beautifully and her heart was fine so as soon as I was in recovery she was given to me to breastfeed immediately, no nicu or long separations. I'd say she was separated for maybe an hour, not ideal, but not the worst situation.

My ideal at this point would be to get her on the breast for all feedings, but if I can't do that, I would at least like to get milk up enough to make the bottle feedings all breast milk. I'm just going to keep pumping like crazy until I can get some answers from my doctor and from another LC who might be able to help witht eh latching problems.

Re: Is it too late/milk not coming in

Thanks for the update, mama! You've been working hard the last couple of days, and that's so admirable for any brand-new mom, let alone one who is recovering from a c-section!

It's pretty normal to get more milk in the morning and then have production decline throughout the day. Levels of prolactin (the milk-producing hormone) tend to peak in the wee hours of the night/morning, which means that most moms notice more milk first thing in the morning. My MIL claims that this is proof positive that babies are meant to be night-feeders.

Originally Posted by @llli*annac

I forgot to mention it in my first post, but I have horrible breasts, so I'm wondering if that has something to do with the problems she is having latching, I was told my nipples are a tiny bit flat, but my breasts themselves are deformed, they aren't full at all, wide set from each other on my chest, and one is significantly larger than the other. I don't know if that has anything to do with it, but I thought I'd throw it out there.

This is interesting, and makes me absolutely sure that you NEED to see an IBCLC. Your description of your breasts (which are not horrible, mama! ) is very reminiscent of tubular hypoplasia. This is a decent article on the condition: http://www.breastfeeding-problems.co...c-breasts.html. Tubular hypoplasia is thought to be quite rare, so I really hope you will see an IBCLC and have her take a look, and not just take a stranger's internet ramblings for a diagnosis.

Re: Is it too late/milk not coming in

Originally Posted by @llli*annac

Also, yesterday we were able to get her successfully latched on a few times, which seems like nothing, but coming from the terrible fits she was throwing and the refusal to latch for a while it is something.

That is definitely something! You are doing all the right things and working so very hard. You should celebrate every victory.

Please do seek out a good IBCLC to help you with this. Nothing beats hands on help from an expert.